Individual
IVAN FIELDS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
7109 GREYSTONE DR, RIVERDALE, GA 30296-2256
(202) 427-2264
Mailing address
7109 GREYSTONE DR, RIVERDALE, GA 30296-2256
(202) 427-2264
Taxonomy
Speciality
Code
Description
License number
State
101Y00000X
Counselor
Primary
—
GA
Other
Enumeration date
09/26/2016
Last updated
09/26/2016
About Stedi
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